Morning Crisis

Yesterday, like a number of days recently, Kate was up at 7:30. That meant I didn’t get my normal walk, nor did I have time to upload a new post. This morning I was up at 5:20. I thought this would be a good opportunity to write a post about an experience we had last night. My plans changed quickly. I was about to walk out of the bedroom when I noticed that Kate was awake. I walked over to the bed to let her know I was going to the kitchen to fix my breakfast. When I reached the bed beside her, I recognized the look on her face. I said, “Are you afraid?” She nodded. I told her I could help her and that she was going to be all right? Then I said, “Would you like me to stay with you?” She said, “Oh, yes.”

She wanted to go to the bathroom. As I helped her up, she said, “You’re very nice to me. You’re the only one I can talk to.” I wasn’t sure if she knew who I was and said, “My name is Richard.” She said, “I know that. <pause> What’s your name?”

After using the toilet, she wanted to brush her teeth. I asked if she were still afraid. She said she was. I asked what she was afraid of. She said, “I don’t know. I don’t know what to do?” She talked a couple of minutes about that and said things like “I don’t know what’s going to happen to all of us.” “I just want to get out of here. I don’t really mean that, but . . .” (She didn’t finish.) “Thank you for helping me. You’re the only one I can talk to.”

I assured her that I could help her, that she could depend on me. I said, “Right now, I think you need to get back in bed and rest. We’re going to have a very nice day.” I started to leave for the kitchen for my computer, and she said, “Please stay with me.” I told her I was just getting my things from the kitchen and would be right back.

As you might expect, I turned on some soft soothing music and sat in the chair beside the bed. It wasn’t long before she was asleep.” I began to think about leaving to fix my breakfast, when she awoke and saw me. She had a smile on her face and said, “You’re here. How nice.” She seemed like herself, but now I feel I should stay a while longer. At least for now, the crisis is over.

A Terrific Morning

Yesterday morning before Kate was up, I posted a tweet that said, “Feeling grateful today. At Stage 7 #Alzheimers, Kate often fails to remember my name or hers, doesn’t know her way around the house, needs help with everything, and is losing her ability to speak, HOWEVER, we still enjoy life and each other.”

I thought a while before posting it for two reasons. First, I don’t want people to think we have escaped all the negative aspects of Alzheimer’s. We haven’t. Second, I don’t want other caregivers whose situations are much different than ours to think they must be doing something wrong or they would also be enjoying life the way we have. From the start, I have wanted to provide an accurate description of our lives. It seems like being able to enjoy life while living with such a devastating disease needs to be told.

After posting the tweet, I realized that my grateful feeling could be easily followed by something that would bring me down from my perch. That could have happened. It is not unusual for us to experience such swings from high to low and back again. I am happy to say that our morning turned out to be a confirmation of our good times.

Kate was up at 7:30, in a cheerful mood, and ready for the day. We were at Panera before 8:30 and back home before 9:30. I wasn’t surprised that she wanted to rest. While she did that, I did a few household chores.

At 10:00, she had rested enough. I asked if she would like me to read a little of Charlotte’s Web. We spent the next hour reading. We both had fun, but I found my voice was getting a bit hoarse. For the better part of the day yesterday and the day before she didn’t recognize our house as ours. I’m not sure whose she thought it was. I suggested that I show her around the house. She was ready.

We spent the next hour walking first through the kitchen, then the dining room, through the living room, and back to the family room. Along the way we made numerous stops as I told her the stories behind many of the pictures, furniture, and other items some of which had come from her parents’ house. She was enthralled. As I expected, she was particularly excited about the variety of things that had been her parents. You might think that because we had so many things of her parents and that I talked about our having them in our home she would have come to realize that she was in our home; however, I never got a sense that she recognized it as ours. In fact, three or four times she asked, “Who owns this house?” Each time I told her that we did, but it never seemed to stick.

Once again, we had had an experience that can be looked on with sadness – sadness that she doesn’t recognize her own home or the many things that should be treasured memories for her. I am just glad that with my help she can experience them in the moment. Yesterday morning was a very Happy Moment for her and for me. I am grateful.

Our Thanksgiving

Like so many other things, Thanksgiving has come and gone. Despite the rough beginning in the early morning hours, it was a nice day though it was bitter-sweet. There was no denying the dramatic change in Kate since last year when we were in Texas with our son’s family. I predicted then that it might be our last Thanksgiving with family, and it was.

I’m not at all sure what next year will be like, but I know Kate’s changes will not be for the better. Kate is unable to grasp this, but I am convinced by the things she says that she recognizes her condition is not good. She was essentially saying that when I went in to get her up for lunch yesterday morning. I said, “It’s Thanksgiving, and I’m thankful that I have you.” She reached up and grabbed both of my arms and said, “And I am thankful for you.” I said, “I know that.” She said, with emphasis and with a slightly sad expression on her face, “I want you to know I really mean it. I mean it.” She knows she couldn’t make it without my help and is very appreciative. I continue to be amazed at her self-awareness.

Since we eat out for lunch and dinner, finding a place to eat on Thanksgiving is a challenge. We did, however, have a good Thanksgiving meal at Ruth’s Chris. For a long time, Kate has been able to get along quite well without anyone’s suspecting she has Alzheimer’s. That is one of the big changes that has occurred in recent months. It was evident yesterday.

As the hostess walked us to our table, she was walking rather quickly. Kate is always very slow. The hostesses at our regular places are well aware and take their time. I decided to let this one know. We hadn’t gone far when I looked behind me and saw that Kate had stopped to talk with a woman at another table. I walked back and discovered that she was complimenting the woman on her hair. She was overdoing it, and I know the woman thought it somewhat strange. When we got to our table, we went through something with which I am accustomed. I am sure that our hostess was not. She was, of course, supposed to wait until we were seated and hand us our menus. It took what must have seemed to her an interminable amount of time for Kate to realize which seat was hers and to be seated. I was glad I had informed our hostess. She was very understanding.

After Kate’s making a few initial comments to our server, I handed her one of my Alzheimer’s cards. I was glad that I had although she might have guessed anyway. Both when I ordered and when the food arrived, Kate asked, “What is that?” She was referring to the sweet potato casserole. She also asked the same question when I ordered a filet for us to split. I think she was confused about the whole situation. We are not regulars at Ruth’s Chris, and it had an air of formality that we don’t experience at most other restaurants. She was very concerned about doing something wrong and asked my advice a number of times. That is not something unusual, but the way she asked sounded like she was more uneasy about this situation.

Despite these things, the lunch went quite well. There were two other couples seated at the tables beside us, but the sound was quite muffled. We felt a certain measure of privacy even though the restaurant was packed. We had a good conversation and talked about the many things for which we are thankful.

Once we were home, Kate wanted to rest and did so for about an hour before getting up. I asked if she would like me to read The Velveteen Rabbit to her. She did. She was more enthusiastic this time than before. Once again, I was also touched. It is so good to see her enjoy herself in this way.

It didn’t take long to finish. Then I asked if she would like me to read some of the Diary of Anne Frank. In spite of her previous interest, I was a little afraid this would sound like too much for her. I am glad to say I was wrong. We read another 20 pages. As I did before, I asked if she wanted me to continue after each entry. We only stopped because it was time for dinner.

It was another good day for us. The meaning of this holiday did not fall on deaf ears. Each of us experienced the spirit of Thanksgiving.

Mornings Are Unpredictable.

Predicting what Kate will be like when she wakes in the morning is challenging. Some mornings she is cheerful. Other days she seems disturbed. Recently we had experienced several especially good days in a row. That came to an end yesterday.

I went into the bedroom about 10:15 when I noticed that it looked like she might be getting up. She was awake, but I quickly recognized that it was one of those times when she didn’t know anything. Her mind seemed to be a complete blank. I spoke to her very calmly and explained that I could help her. I began to tell her a little about her mother and father and mentioned that we had some photo books I could show her. She didn’t want to get out of bed, so I brought in her “Big Sister Album.” I showed her a few pictures, but the light was too dim for her to see well as she was still lying in bed.

We went through our usual routine of her asking and my telling her my name and hers, but nothing sounded familiar. Very early I told her I was her husband. She didn’t take to that, and I said, “Just let me be your friend.” That worked.

She told me she didn’t know what to do. I suggested that she get up and go to the bathroom and then get dressed. She surprised me by taking my suggestion. She was a bit insecure as we headed to the bathroom and held my hand all the way. Once there, she depended on me to tell her what to do.

When we finished in the bathroom, we went back to the bedroom where I proceeded to help her dress. She had everything on but her shoes when she wanted to lie down. About twenty minutes later, I told her I would like to show her something that I thought she would like. She got up without a problem. She put her shoes on, and we walked to the hallway outside our bedroom where I showed her pictures of her mother and grandmother. She wasn’t as interested as usual but did enjoy seeing her mother’s photo. Things were getting better. Several times she asked, “Who are you?” I gave her my name without indicating our relationship. That seemed to suffice.

Once in the family room, I picked up the “Big Sister Album” and showed her the cover photo of her and her brother. She sat down in a chair to look at it. She took interest in the photos of the little girl but didn’t know who she was. I pointed at one in which she had taken special interest and said, “That’s you.” She said, “What’s my name?” I told her. She was elated and said, “Now I have a name?” It was a special moment of joy for both of us.

A few minutes later, the sitter arrived. I met her in the garage and explained what had been going on. She asked if she should still take her to lunch. I told her I thought that would actually be helpful for her. Then we walked into the family room. I said, “Look who’s here. Your friend Cindy, and she is going to take you to lunch.” Kate received her enthusiastically and said a loud “Yippee!” I was relieved and left for Rotary. Kate didn’t express any reservations about my leaving. She was happy, and so was I.

 

This Morning

At 7:35 this morning, I glanced at the iPad connected to the video cam and noticed that Kate was getting out of bed. She was already on her feet when I reached her. She smiled at me, and I said, “Looks like I got here just in time.” She said, “Yes, I’m glad to see you.” She wanted to go to the bathroom. I took her hand, and we headed that way. She said, “You’ve done this before.” I said, “Yes, I have.”

She was a little unsteady on her feet; otherwise she seemed perfectly normal and recognized exactly who I was. I had to explain what she was supposed to do when we got to the bathroom. She almost always looks at the toilet as though she doesn’t know what it is for.

I took her back to bed and pulled the covers over her. She thanked me. I told her I would be in the kitchen and to call me if she needed anything. She said, “What’s your name?” I told her and said, “And what’s your name?” She looked at me as though I should know, and I said, “Kate.” She smiled and said, “That’s right.” I am sure that she hadn’t remembered but was covering herself by waiting for me to tell her. She still has at least some ability to hide her memory problem though she almost always asks me her name. She never seems bothered by asking me the names of other people even those closest to her like her children and her mother and father.

We Still Have Happy Moments

In my last post I mentioned a sad moment Kate and I had experienced when she was so disturbed about the way she looks. I’d like to balance that with a couple of happy moments. We still have them, and they seem more important now than ever before. I think about “moments” more lately because it seems harder for me to describe a full day in a single word.

Two times in the past few days we have had an especially good time looking through her family photo books. Both of those occurred after her afternoon rest. In each case, I took the initiative of suggesting we sit down side by side and look at one. I make a point of that because she often looks at the cover of one of her books, but she doesn’t spend much time with them by herself. I think it must be that she doesn’t recognize the people, at least most of them, and she doesn’t have the ability to recall or imagine anything about the pictures or the people in them. She needs someone to give her specific names and information that provides the context for what her eyes see.

As it is for other activities we share together, I have as much fun going through the photo books as she does. Of course, a significant aspect of the pleasure for me is seeing her eyes light up and hearing her enthusiasm as we look at each photo. She continues to comment on people’s smiles and their eyes. Her primary interest appears to be in the mood of each person. I don’t recall her mentioning anything about clothes that people wore or anything else. She does say good things about her family as a group. Her strongest feelings are for her parents, especially her mother, but she expresses those mostly when she looks at some of their framed pictures around the house.

I find these moments a good substitute for our afternoon trips to  Barnes & Noble. We rarely go there now. When we finish, it is about time for dinner. It sets a nice tone to our relationship that extends until bedtime. That remains the most predictable good time of the day. I think that is because neither one of us feels any pressure. It’s a time when we just relax together.

Yesterday Kate was in a good mood when she got up, and it lasted all day. At lunch we had another happy moment. Kate was unusually talkative. I can’t begin to remember all the things she said. A lot of it involved how fortunate she and I have been. She was upbeat about everything.

There was a sad moment, however, when the server stopped at our table and said something nice to Kate. After she left, Kate commented on that. She specifically noted that the server had talked to her and that people usually talk to me. I have noticed the same thing. She didn’t seem disturbed about it. I think there are two things that account for that. One is that people don’t know what to say. The other is that Kate is slow to respond. That makes it hard for her to play an active role in a conversation with three or more people.  The conversation then drifts to one between the others and me.  Maybe that is why conversations like the one we had yesterday mean so much. She is relaxed and can be herself.

Last night we had dinner with a couple we know from our music nights at Casa Bella. We arrived first, and Kate already seemed like she needed to prepare herself. As she often does when it is just the two of us, she picked up the menu. She quickly found that she couldn’t read it and asked me what she should get. I explained that she usually gets either the Tortelloni alla Stephania or the Tortelloni alla Panna. I told her I would order for her and that she had the Stephania last week, so she might like the alla Panna this week. She tried several times to pronounce it.

About that time, our friends arrived. As soon as they were seated, Kate asked their names. She tried to repeat them back and was able to do so after a couple of tries. Of course, she forgot them immediately, so she asked again several times back to back before stopping.

Then she gave her attention to what she should order. I told her I thought she would like the Tortelloni alla Panna. She tried unsuccessfully to pronounce it. Then she asked Lisa. She and Lisa worked on the pronunciation a few times. Fortunately, the server came for our order a few minutes later, and I gave her our orders. Kate was off the hook. She must have felt a sense of relief to have that hurdle behind her.

She really wanted to be a part of the conversation, but it was too hard for her. Lisa is a fast talker. Ben speaks softly. At first, she kept asking each of them to repeat things that she didn’t understand. After a while, she just gave up. Because it was such a challenge for Kate, I thought this was likely to be one of the last times we get together. When we said goodbye, I asked Kate how she had enjoyed the evening. She said she enjoyed it.  She didn’t seem bothered in any way. Nevertheless, I believe situations like this may become even more difficult in the future. I will certainly stop them if that happens. Until then, I think it is good for both of us to have the additional stimulation of being with other people.

Experiences like this make our happy moments together even more important. I am optimistic that we still have a lot of them in the days ahead whether it is just the two of us or with others.

The Longest Time Kate Has Not Remembered Me As Her Husband

The past couple of days have been similar to a few other days this past week. Once again, Kate was up early. Shortly after getting to the bathroom, she said, “Who are you?” I gave her my name and told her I was her husband. She said firmly, “No.” I said, “I’m a friend, and I can help you with anything you need. She didn’t ask again until we were on the way to Panera around 9:00 when she asked, “Why am I with you?” I said, “Well, you’re my wife.” She gave me a look of astonishment and said, “What’s a wife?” I explained, but she was not ready to accept that we are married. I said, “Let’s say we’re very good friends.” That usually works, but it didn’t this time. She didn’t want to hear that either. At Panera, the subject came up again with the same reception. Except for her reaction each time I told her we were married, she acted very normally with me. Nothing would have suggested that we weren’t husband and wife.

At lunch, I said, “I think I might make you my girlfriend for life.” She was insistent that would not happen and told me not to say anything more. I didn’t until we were on the way home from dinner when she said, “Why am I with you?” as she had done that morning. I gave her a similar response and she did the same. I didn’t say anything more until she was in bed. I sat down on the bed beside her. She smiled at me, and I said, “I love you. Do you know how long we have been married?” She smiled again and said, “How long?” That was the first sign of recognition the entire day.

Kate started the day even earlier this morning. She was awake at 6:20 when I got up. I asked if she wanted to got to the bathroom. She said, “Not right now.” I told her I would be in the bathroom and to call me if she needed me. I had just gotten to the bathroom when she called.

She used the toilet and then asked, “What now?” She pointed to the shower. I hesitated a moment because it was so early. I knew she would want to go back to bed. Sometimes, however, she doesn’t want to shower. I quickly decided this was an opportunity I didn’t want to pass up. I told her I would get the shower ready for her. Before getting in, she asked, “Who are you?” When I told her my name and that I am her husband, she didn’t believe it. I told her we were friends. That worked.

After her shower, she wanted to lie down again. I turned on an album of cello adagios at a soft volume. I dressed and told her I would be in the kitchen and to call me if she needed anything. I asked if she wanted me to turn off the music. She said, “Oh, no. Please leave it on.” It was one of a number of reminders in the past few days of how much she enjoys music. It is now 8:30.

BREAK

It is now 10:15. Right after my earlier entry, I heard her say something. I went to the bedroom. She hadn’t called me. We spoke for a few minutes. She surprised me when she wanted to know who I was. I gave her my name and told her I was a friend and that I could help her with anything she needed. She didn’t show any signs of wanting to get up, but it also didn’t look like she was ready to go to sleep. I asked if she wanted to get up. She said she did but needed some clothes. I told her I would get them. She was surprised that I would know where to find them. I told her I knew a lot about her and that I knew her parents. She asked their names. Then she asked my name. I said, “Kate.” She recognized her name and asked for her full name. I said, “Kate Franklin” (her maiden name). I got her dressed without a problem. Even if she didn’t remember that we are married, she clearly trusts me.

The first real spark of life came when she reached the family room. She noticed all the usual things, the room, the flowers, the flowers on the patio, the back yard, and the photos. We spent about fifteen minutes just looking around as she enjoyed what she was seeing. When we started for the kitchen where I had laid out her morning meds, she said, “Don’t you hate to leave this place?” I explained that it was ours and that we would be coming back after getting her a muffin. She was surprised and happy.

We are now at Panera. She stopped working her puzzles and is finishing up her muffin. That means we will probably head back to the house shortly. We won’t be there long before going to lunch. She is happy. I am happy. I am optimistic about the rest of the day.

A Repeat of the Previous Two Days, But . . .
I look at yesterday as another good day, but I have to qualify my judgment. It was good in terms of Kate’s and my relationship. It was not good in terms of the increasing signs of her decline. The past three days have involved a variety of symptoms that signal that she is changing. Let me give you a sense of what the day was like.

Because she had lost sleep night before last, I let her sleep a little longer yesterday. When I went to wake her, I found that she was already awake but didn’t want to get up. My sense was that she responded like a person who was depressed. It wasn’t that she felt a need for sleep but that she just didn’t want to face the day. That is something I have observed on a number of other mornings in recent weeks.

She didn’t remember who I was, but she was cooperative when I invited her to lunch and told her I would help her get ready. Like the day before, she didn’t show any “spark” or sign of enthusiasm until she walked into the family room and saw her flowers. We enjoyed music on the way to lunch. When we arrived at the restaurant, she seemed fine in terms of her mood. She displayed no sign of depression and had a good time at lunch.

She wanted to rest as soon as we got back to the house. As she did the day before, she went to sleep. That has not been typical for her. Not only that, but when she awoke after at least an hour, she didn’t want to look through her photo books or anything else. She just wanted to continue resting. Like the day before, she was very relaxed and peaceful. She was content with no sign of worry. She was “at home.” We spoke for a few minutes. Then she rested but didn’t appear to sleep. Later I told her I wanted to show her something. I didn’t tell her what, but she agreed to look. It was a slide show of photos taken during a trip we took to Bruges and Amsterdam. I was particularly interested in her seeing these photos because there were so many taken at Keukenhof Gardens. I knew that she would enjoy the beauty of the floral displays, and she was. The problem was that she was still tired and wanted to stop after a short period of time. She didn’t go to sleep but rested another forty-five minutes before I got her up for dinner.

At dinner, she displayed more confusion. It began with what is becoming commonplace. She had trouble determining where she was to sit even though I was standing by the seat and pointing to it while I said, “You can sit right here.” When our server brought the bread, she didn’t know what it was or how to eat it. I buttered several slices and put them on her bread plate. Instead of picking up a piece of bread and taking a bite, she used her fork to pick it up. It was awkward for her as she tried to put it in her mouth. I suggested she try picking up a piece with her hand, and she did better. When the meal came, she didn’t know what the rice was, but she liked it as always.

After getting home, I asked if she would like to work puzzles on her iPad while I watched the news. That sounded good to her. It wasn’t long before she was stumped. I tried to help, but that came down to my actually putting the pieces in place for her. She tried another one but was frustrated and wanted to get ready for bed.

I turned on the debate as I prepared to take my shower. Then I asked Kate if she would like me to turn it off. She said she would like to listen a while. She didn’t watch, but she was still listening when I got out. I know she doesn’t know any of the candidates and she couldn’t understand what they were saying. I think she just found it a satisfying distraction. When I went to bed, she was almost asleep. She was very relaxed and seemed to know me.

As I reflect on the past few days, I have thought about two other friends who had spouses with dementia. I had been with them and their spouses less than six months before they died, only a few weeks for one of them. In each case, I was very surprised when they passed away. I had no idea when I saw them that they were so close to the end. Wayne Abernathy called me on Saturday. We had a long conversation during which he talked a lot about the last few months of his wife’s life. He saw it as a time when his wife simply slowed down. As he talked about his experience, it made me wonder if Kate might be at the beginning of this same stage.

I also thought of our friend Nancy Hardwick who lives in Dallas. Her husband died a few weeks after we had dinner with them in 2017. He, too, slowed down after we left. He began to sleep more and said to her, “You know I’m dying.” He was gone in less than three weeks.

I don’t pretend to know what lies ahead. I know that Kate’s mother lived with us almost five and a half years with minimal ability to speak or get around on her own. I don’t want Kate to do the same. I am coming to that place I have heard other caregivers talk about. There is a point at which you believe it is better for the one you love to die than to live. I’m not there yet. For the first time, however, I am beginning to think seriously about her passing and hoping the end will come in a way that is similar to that of Wayne and Nancy’s spouses.

Kate’s Aphasia

I am not sure why, but among all the things that I’ve thought about, aphasia has been low on my list. I was well aware that if Kate lives long enough she would not communicate, but I didn’t think that she would begin this process now.

She has had some minor difficulty with her speech for about a year. The problem is progressing more rapidly now. Everyday words like pizza, olives, and hamburger are beginning to drop out of her vocabulary. Sometimes I joke about being her butler. She no longer knows what a butler is. Yesterday, I pointed to a fence that is being installed around a nearby hospital. She said, “What’s a fence?” At lunch, she saw her napkin and said, “What’s this?” I told her it was her napkin. She said, “What do I do with it?”

Some things are understandable. The other night we had dinner at a Mediterranean restaurant. She wanted a dessert and asked what they had. I told her they had baklava. She had no idea what that was even after I brought a piece to her. That is not something that is an everyday part of her vocabulary, so I’m not surprised that word is lost.

Quite often she knows what she wants to say but says the wrong word. A couple of days ago, she said, “I don’t want to swim.” She meant “I don’t want to sing.” While working on her iPad last week, she said, “I got two boys. She meant two puzzle pieces. Another time, she was joking with me and said, “I’m going to put it on your bed.” She meant my head. Another time, she said, “I want to yell you something” instead of tell you something. If I could remember, the list would go on and on.

It goes beyond her vocabulary. She is also beginning to struggle putting words together to communicate what she wants to say. She often starts to tell me something but stops because she doesn’t know how to express it. She looks to me to know. Sometimes I do, but often, I don’t.

So, how do I feel about this change? As you would expect, I am disturbed. Alzheimer’s began to affect our conversation very early. That was related to her memory loss. Since she could not remember things, she was left with little to say. For a good while now, she has talked more, but the conversation always revolves around a set of familiar things. We recite these over and over. Despite the repetition, I enjoy being able to converse with her no matter what we talk about. I especially enjoy seeing the pleasure she gets out of it as well. The thought about her losing this ability is one I don’t want to face.

Having said that, I stop and think about how well we have gotten along so far. It really is possible to enjoy ourselves without her having a memory. It would have been quite different if she had also lost her sight, hearing, and feelings for people and the world around her. That has carried us a long way. To adapt a phrase from “Swing Low Sweet Chariot,” I hope it will “carry us home.”

Insecure, Confused, but Happy and Appreciative

It would be quite an understatement to say that Kate is changing more now than at any other time since her diagnosis. Day before yesterday was a good example. Just as I have been adapting to her getting up late, she has surprised me several times over the past week. That morning she was up at 7:30. That’s at least three hours earlier than when I usually begin to wake her. It was also a day when she seemed comfortable with her surroundings. She acted like she knew I was her husband but didn’t. She was very dependent. She wanted my directions on almost every step from getting out of bed to where to go when I got her dressed. She was eager to have a shower, something I was happy about. She often resists.

We made it to Panera before 9:00 where she worked happily on her iPad an hour. Then I noticed that she was not working her puzzles, just sitting and looking a little discouraged. It was obvious she was frustrated. When I looked at what she had done, she had completed all but two pieces and couldn’t figure out where they went. I showed her, but she couldn’t understand. I put them in place for her. I felt sure that she was tired from having gotten up so early. It was early for lunch, but I decided it would be better than going home where she might nap and then have a hard time getting up.

She was quiet on the way to the restaurant. As I was helping her out of the car, she said, “I want to thank you. I feel better.” I told her I didn’t think I had done anything special but that I want to do anything I can to help her. She looked at me very seriously and said, “You do. You have no idea how much.” I am still not entirely sure what she was thinking about. It might have been the way I responded to her when she was frustrated over her puzzle. It could also have been that she imagined something as we were driving to the restaurant. As we walked to the entrance, she stopped as she always does to look and comment on the flowers just outside the door. When our server greeted her and asked her how she was doing, Kate said, “I’m doing much better now.” That’s exactly how it seemed. She was fine the rest of the day.

Eating early allowed us to get back with plenty of time before the sitter. I felt sure she would immediately head to the sofa for a nap. Instead she started working a puzzle on her iPad and continued until just before the sitter arrived. Then she decided to rest on the sofa. That’s where she was when Mary came. She greeted Mary with enthusiasm. When I told her I was leaving for my platelet donation, she smiled and said goodbye. She didn’t look at all unhappy to see me go.

When I returned, she was seated on the sofa looking at a photo book. She said, “We need you.” I took note of the fact that she said “we” and not “I.” Then Mary told me that she had not napped and explained that Kate had wanted to go outside. She stooped down to look at something in the yard or near a shrub, lost her balance, and couldn’t get up. Mary helped her but said it was difficult. I know what she means. I find that it is getting a bit challenging to get her into a sitting position when she is lying on the bed.

From what Mary told me, Kate had been a little upset and confused, but she was calm when I got home. The only problem then was that she was hot from being outside. I got out a small floor fan and used it to cool her off. Fifteen minutes later, she was fine again and ready for dinner.

At dinner we encountered something that is becoming a regular part of our dining experience now. She has difficulty knowing where she should sit. I always walk to her chair and pull it out from the table. I use my hand to direct her to the seat and say something like, “Sit right here.” Almost without exception, she interprets that as my chair and goes to the chair across the table from me. Sometimes I accept the chair she has chosen. When I have a specific reason for choosing a different chair, I may simply take her hand and guide her to the chair I selected. This, and the fact that she is very careful as she takes her seat, means that it takes longer for us to be seated than most hostesses are prepared for. Most of them seemed to be trained to remain at the table until you are seated. Of course, since we are regulars at all the places we visit, the hostesses are well aware of Kate’s diagnosis and are very understanding.

During dinner, Kate talked a good bit about what I do for her and how much she appreciated that. I told her our son was coming for a visit the next day. During our conversation, we spoke very naturally about our marriage. She commented on how happy we had been and then said, “What’s your name?” I told her, and she asked her own name. I am still amazed at how casually she does this. It’s the kind of experience that is both happy and sad. I am happy that she doesn’t seem frustrated, but it is also sad that she can’t remember. It makes me think about all the things she must not know if she is forgetting her own name and mine. What is it like to look around and not know who or what anything is? The good thing is that she still responds intuitively to people and things around her and still likes so many things. She continues to get pleasure out of life. That is something that may be hard for people without dementia to understand.

Later that night when we were in bed, she mentioned how good she feels when she is in Texas. I could tell by the way she said it that she thought she was in Texas at that moment. I didn’t say anything to dissuade her. She was happy. That’s a good way to end the day.